Spontaneous pneumothoraces are a common pathology with recent clinical trial data not yet incorporated into published guidance, leading to potential variable approach by physicians in the management of this condition. Hallifax and colleagues (Respir Res 2022;23:23) undertook the first national survey of clinical management of pneumothoraces across the UK to document current practice in the context of published guidance and more recent clinical trials. Of 103 respondents, it was seen that for initial management, only 50.5% would manage a primary pneumothorax without symptoms conservatively dropping to 2.9% if the patients has ongoing symptoms. For secondary pneumothoraces, 62.7% would insert a drain with minimal symptoms and this rises to 95.1% if the patient presents with symptoms. Ambulatory pathways were only an option for 28.2% of participants. Methods of clarifying if there was cessation of the air leak varied between observing a ‘lack of bubbling’ on coughing (35.3%), digital suction devices (13.7%) or by clamping and reimaging for accumulation of pneumothorax (18.6%). There was a similarly wide range of practice regarding clamping, use of suction and postchest drain removal imaging. The authors highlight recent evidence …

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杂志社

自发性气胸是一种常见的病理学，最近的临床试验数据尚未纳入已发表的指南，这导致医生在治疗这种疾病时采用了潜在的可变方法。Hallifax 及其同事 (Respir Res 2022;23:23) 在英国进行了首次全国性气胸临床管理调查，以在已发表的指南和最近的临床试验的背景下记录当前实践。在 103 名受访者中，可以看出，对于初始管理，只有 50.5% 的人会在没有症状的情况下处理原发性气胸，如果患者有持续的症状，保守地下降到 2.9%。对于继发性气胸，62.7% 会在症状轻微的情况下插入引流管，如果患者出现症状，这一比例会上升到 95.1%。只有 28.2% 的参与者可以选择走动路径。确认漏气是否停止的方法各不相同，包括观察咳嗽时“没有起泡”（35.3%）、数字吸引装置（13.7%）或通过钳夹和重新成像以发现气胸积聚（18.6%）。关于钳夹、使用抽吸和胸后引流去除成像也有类似的广泛实践。作者强调了最近的证据……